Fear, Pain, Denial, and Spiritual Experiences in Dying Processes.

The study included only dying patients with cancer in Eastern Switzerland, so the findings may not apply to patients with other illnesses or cultural backgrounds. This was an exploratory observational study, not a trial of any treatment. Observations were subjective evaluations and were influenced by staff culture and interventions. Periods between observations were unrecorded, even though patients were observed 2 to 8 times daily. Some periods of peace or post-transition may have been medication-induced. Subgroups and interpretation of suffering were found by consensus, not by predefined criteria. Observation of spiritual experiences could be biased by the observer's attitude and may explain differences between the two sites.

The authors declared no potential conflicts of interest and received no financial support for the research, authorship, or publication.

Do not read these observations as proof that spiritual experiences or transition stages cause a peaceful death. The study did not test any treatment, and assessments were subjective and possibly influenced by medication and staff culture.